NPIMap

Organization Active NPI

Randall W. Stettler, DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • La Mesa, CA
National Provider Identifier
1790102127
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
39089 Issued in CA
Legal business name
RANDALL W. STETTLER, DDS, INC
Practice address
5565 Grossmont Center Dr
Building 1, Suite 129
La Mesa, CA 91942-3020
Phone
(619) 463-4486
Fax
(619) 463-6553
NPI assigned
Mar 24, 2014
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Randall W Stettler, DDSNPI 1124244686
Title
President
Phone
(619) 463-4486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 39089 CA Primary

Addresses

Primary practice location

5565 Grossmont Center Dr
Building 1, Suite 129
La Mesa, CA 91942-3020

Mailing address

5565 Grossmont Center Dr
Building 1, Suite 129
La Mesa, CA 91942-3020
Phone (619) 463-4486

Other practice location 1

8881 Fletcher Pkwy Ste 105C
LA Mesa, CA 91942-3134
Phone (619) 463-4486

National Provider Directory

National Provider Directory

Locations

5565 Grossmont Center Dr
Ste 129
La Mesa, CA 91942
Phone (619) 463-4486

8881 Fletcher Pkwy
Ste 105C
La Mesa, CA 91942
Phone (619) 463-4486

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1790102127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BUILDING 1, SUITE 129",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-463-4486",
            "fax_number": "619-463-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BUILDING 1, SUITE 129",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-463-4486",
            "fax_number": "619-463-6553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8881 Fletcher Pkwy Ste 105C",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919423134",
            "country_code": "US",
            "telephone_number": "619-463-4486",
            "fax_number": "619-463-6553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RANDALL W. STETTLER, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "STETTLER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-463-4486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "39089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.